Shoulder Pain Treatment in Yarmouth, ME

Shoulder pain is a common issue that affects up to 70% of people at some point in their lives. The shoulder or glenohumeral joint is the most mobile joint in the body. Its structure allows for a wide range of activities, from throwing a ball to scratching your back. The shoulder complex includes three joints that functionally work through the combined motion of your collarbone, shoulder blade, and actual shoulder joint. Additionally, the shoulder directly relies on 17 different muscles and many more indirectly working together for stability and motion. The inherent instability and overall complexity make the shoulder prone to dysfunction and injury. For this reason, shoulder pain is a common complaint we treat at Brown Chiropractic.

There are many potential causes of shoulder pain. Faulty postures and movement patterns can develop for various lifestyle reasons. Repetitive incorrect movements cause pinching of soft tissues called impingement, which can cause inflammation and pain. The soft tissues begin to break down and become degenerative, sometimes resulting in acute rupture or, over years to decades, arthritis. It’s essential to understand that if your shoulder pain is related to faulty movement and joint misalignment, it won’t subside until you address the underlying issue. Chiropractors specialize in identifying the root cause of shoulder pain to provide effective treatment.

Shoulder pain can take the form of acute discomfort or persist as a chronic condition. While about 50% of shoulder pain cases resolve within 8-12 weeks, a significant 40% become chronic, lasting more than a year. When treating shoulder pain, conservative care is the gold standard. Over-the-counter pain relievers and anti-inflammatories will mask the pain and inhibit healing. Repeated studies show that conservative management of rotator cuff tears and other shoulder-related pain is as effective as steroid injections or surgery. In fact, conservative management can have superior outcomes compared to long-term interventions (5 years). Steroid injections are associated with a 7.44x higher risk of rotator cuff rupture and should be avoided. Instead, we recommend a well-rounded manual therapy approach, therapeutic exercises and stretches, and chiropractic modalities to stimulate tissue healing. All of which we offer here at Brown Chiropractic.

Comprehensive Consultation and Exam

Identifying the root cause of the problem

The first step to treating shoulder pain is a thorough consultation where we get to know you and understand your symptoms, their effect on your life, and your goals for care. We then perform a comprehensive evaluation, which includes orthopedic and neurological testing to identify which tissues of your shoulder are injured and painful. This will also rule in or out shoulder pain from your neck and includes an evaluation of neck and upper back segments. Lastly, a functional movement screen is needed to determine abnormal postures, muscle imbalances, and dysfunctional movements that probably contributed to overloading and damaging tissues in the first place. We specifically screen the functional ability of your shoulder blade and its relationship to your shoulder.

All of this is designed to get to the root cause of your pain so your care can be effective and efficient. If we identify that further testing is necessary, we can order X-rays or an MRI. Similarly, if we feel that a collaborative approach to your shoulder pain is necessary, we can work with your PCP or refer you to specialists, including orthopedists, physiatrists, neurologists, and more.

Specific Chiropractic Care in Yarmouth, ME

Adjustments and joint mobilization to restore mobility

The shoulder functionally is a complex system of joints. The glenohumeral joint, where the humerus meets the scapula, is the most recognized. However, the AC joint, where the collarbone connects to the scapula, and the SC joint, where the collarbone meets the sternum and the function of the scapulae on the rib cage, all contribute to shoulder function. Disruption of the kinetic chain or restrictions and misalignments can cause shoulder pain. Our chiropractors are well-versed in making precise adjustments to all the shoulder joints to alleviate pain and restore mobility.

Additionally, our chiropractors recognize that our regional body function is interconnected. Shoulder discomfort frequently includes dysfunctional joints and tissues in the neck or upper back. Upper back stiffness and immobility is a common finding that alters shoulder blade movement, disrupting the kinetic chain. Many of the muscles that attach to the shoulder directly attach to the neck and upper back. It is common for someone to have a primary complaint of shoulder pain with secondary complaints of neck and upper back pain. Because of this, we take a holistic approach to treating your body, getting you faster relief while optimizing your recovery.

Manual Therapy and Myofascial Release

Reduce muscle tension and pain

At Brown Chiropractic, our approach to effectively treating shoulder pain relies on the skillful application of myofascial and manual therapy. The shoulder area comprises an intricate network of muscles, and the strains of daily life often lead to tightness and discomfort in these muscle groups. Indeed, muscles can be the primary cause of shoulder pain. Trigger points that develop in the rotator cuff can be especially painful and can mimic a rotator cuff tear in pain severity and disability. Restoring normal muscle tension can not only provide relief of pain. It creates a window of opportunity for exercises to be more effective for strengthening weak muscles and normalizing biomechanics.

Our chiropractic physicians employ a wide variety of techniques and approaches based on your needs. These include trigger point and myofascial releases to ease muscle tension. Pin and stretch techniques to break up myofascial adhesions and functionally lengthen muscles. Tool-assisted soft tissue scraping and release techniques, including the Graston Technique. We use these techniques to break up scar tissue and myofascial adhesions while stimulating collagen synthesis and alignment to improve healing. Whatever your touch preference or tissue need, we will have the soft tissue options that will work for you.

In our examination, our experienced doctors identify weak or restricted areas in your shoulder. Then, they collaborate with our trainers to create a personalized exercise plan to address your specific needs. Whether your shoulder needs strengthening for weakness or more flexibility for stiffness, we aim to accurately diagnose your condition and guide you toward the right path for recovery.

Deep Tissue Cold Laser

At Brown Chiropractic, we embrace advanced technology to effectively manage musculoskeletal issues such as shoulder pain. Cold Laser directs infrared light into the tissues and works through photobiomodulation. This reduces inflammation and speeds up the healing process. A typical treatment is quick, lasting only three to five minutes, and is remarkably comfortable. At most, you’ll experience a gentle, soothing warmth in the treated area.

Shoulder Impingement

Shoulder Anterior Impingement Syndrome (SAIS) is a painful condition with overhead activities. It occurs when the shoulder bones trap the supraspinatus tendon, primarily during arm elevation and internal rotation. This repetitive impingement can lead to shoulder issues, including supraspinatus tendon disruption, subacromial bursitis, biceps tendonitis, and rotator cuff rupture. It’s important to note that around 95% of chronic rotator cuff tears are linked to impingement.

Impingement can result from acromioclavicular degeneration, osteophytes, a thickened coracoacromial ligament, or a diminished subacromial space. Factors like upper crossed syndrome and scapular dyskinesis (abnormal control and motion) play a significant role in predisposing individuals to SAIS. This condition often presents as pain during overhead activities, reaching behind the back, or even at rest, with nighttime discomfort being common. Clinical signs can include a reduced range of motion, a painful arc raising your arm to the side, and tenderness in various shoulder areas.

SAIS management typically starts with restoring the range of motion while avoiding aggravating movements. Physical therapy, including soft tissue manipulation and exercise, are critical treatment components. Strengthening exercises may begin incrementally, while stability training aims to restore proper posture and joint function. It’s essential to emphasize these conservative methods before considering more invasive approaches, as evidence suggests that surgical interventions don’t necessarily provide significant advantages over conservative therapies in the long run.

Rotator Cuff Issues

The shoulder is a highly mobile ball-and-socket joint, and the rotator cuff is critical in maintaining stability. Comprised of the tendons of the supraspinatus, infraspinatus, teres minor, and subscapularis, the rotator cuff interacts with the shoulder joint capsule. This intricate system is responsible for stabilizing the shoulder during movement and protecting it from dislocation.

Rotator cuff injuries are pretty common, leading to approximately 4.5 million physician office visits each year. These injuries and issues with the AC joint tend to increase with age. While they can result from single traumatic events, over 90% of these injuries are attributed to a combination of factors, including repetitive stress and age-related wear and tear.

A good metaphor for developing rotator cuff tears is if you can imagine the supraspinatus tendon as a rope. If you took a rock and hit the rope over and over, it would be fine, but if you did it over months to years, you would fray the rope and cause tearing. In the case of rotator cuff tears, the rock pinching of the tendon against the bones in the shoulder is impingement caused by poor biomechanics of the shoulder girdle. This is another reason to address poor posture and screen your shoulder function, especially if you have a history of chronic shoulder pain.

A full-thickness tear, often referred to as a complete tear, creates a hole or a slit in the tendon. These tears commonly commence in the supraspinatus but can involve the infraspinatus and subscapularis. Numerous factors predispose the rotator cuff to damage, including obesity, genetics, diabetes, and a history of corticosteroid injections. Impingement and hypovascularity may lead to recurring damage and hinder the cuff’s ability to recover. Care initially focuses on reducing inflammation and pain with laser and soft tissue. Although the tear itself typically does not repair, normalizing biomechanics and posture while strengthening the rotator cuff can restore function to the shoulder complex.

Frozen Shoulder

Adhesive capsulitis, often called “frozen shoulder,” is characterized by persistent and painful limitations in active and passive shoulder movements. The pain is progressive and can include night pain along with difficulty with daily activities. People often notice this condition at first as limiting their ability to put on a shirt. This condition is categorized as either “primary” or “secondary” – primary adhesive capsulitis develops without a clear cause, while secondary adhesive capsulitis is typically linked to a preceding event or condition, such as shoulder trauma or surgery.

Adhesive capsulitis typically progresses through several stages. The “freezing” stage is where individuals experience gradual, painful loss of shoulder motion. This is followed by the “frozen” stage, characterized by significant pain and further motion restrictions due to fibrosis and adhesions in the shoulder. Finally, the “thawing” stage, during which pain and stiffness diminish, but it may take up to nine months or more to regain a functional range of motion. This condition can affect 2-5% of the population, and it’s more common in individuals with Type 1 or Type 2 diabetes, thyroid disease, or those between the ages of 40-65, with a peak incidence around 51-55 years old.

Treatment options include various manual therapy techniques, stretching exercises, and, in some cases, interventions like oral corticosteroids, intraarticular corticosteroid injections, and even surgery. The natural course of the condition can be lengthy, lasting up to 18 months or more, so understanding its chronicity is crucial to managing expectations.

In our experience, care is focused on pain relief and management until the “thawing phase,” as exercises and stretches can be extremely painful and without benefit before then. Once thawing starts, restoring full range of motion and normalizing biomechanics of the previously limited shoulder to prevent future occurrences and development of other shoulder conditions is essential.

Bursitis

Within and around your shoulder joints are minuscule fluid-filled sacs known as bursae. These sacs serve as delicate cushions that allow tendons and muscles to slide over bones without irritation. However, factors like overuse and degenerative changes or injury can cause these bursae to become inflamed, leading to bursitis. Typically, bursitis induces discomfort, primarily localized on the upper or outer regions of the shoulder. Raising your arm or performing circular motions can exacerbate this condition.

While conventional treatments often involve medications and injections, effective natural remedies exist. Cold Laser therapy is a notable method for bursitis treatment. This therapy employs light energy to mitigate inflammation within the bursae to promote proper healing. Additionally, gentle exercises and manual therapy can aid the healing process, and our rehabilitation specialists can provide expert guidance for their safe and effective execution. For self-care at home, applying ice at regular intervals throughout the day is recommended. This practice reduces inflammation and alleviates pain, significantly aiding the healing process.

Osteoarthritis

Osteoarthritis, or Degenerative Joint Disease, is a condition that gradually wears down the affected joint. This wear and tear reduces joint space and inflammation, leading to pain and limitations in the shoulder’s mobility and function. Several risk factors can contribute to the development of osteoarthritis, including age, body weight, prior injuries, and the repetitive stress placed on the joint over time. While this condition affects various joints, it’s common in the shoulder. It’s crucial to recognize that osteoarthritis is irreversible. However, effective management can slow down its progression and prevent further degeneration. This is why early treatment is critical

Brown Chiropractic employs chiropractic adjustments, soft tissue, and stretches to restore what motion is still available. We then strengthen around the joint and address the global posture that contributed to the wear and tear in the first place. With diligent management, we can minimize the effects of osteoarthritis, allowing you to enjoy your life and the activities you’re passionate about.